The value of a modern RMS system
We threaten our organization’s resiliency and progress when we make opinion-based decisions
Futurist Ray Kurzweil’s predictions about trends in technological advancement, which have been correct 86% of the time, are widely followed by governments and large companies around the world. Kurzweil predicted that computers will double their capabilities every 12 to 18 months, along with the information technologies that use them. Among his other predictions are that we will experience 32 times more technological advancement in 5 years and 1,000 times more in 10 years. It is hard to imagine what that will translate to for 21st-century fire and emergency services, but it will undoubtedly change how local response agencies do business.
For years, EMS leaders simply used their words and opinions to explain department needs, and those words were considered facts. Chiefs could justify purchases, policy changes and directives based on experience and gut instinct. Although the opinions were often accurate, our world has evolved with a reasonable request: Back up that opinion with data, and your success will substantially improve.
As this pertains to the EMS, agencies have long been required to track records related to patient care, incidents and personnel. An agency’s records management systems (RMS) is critical to its administrative and technical infrastructure. It enables state reporting, creates historical records, and collects the data necessary for making decisions. Now, regulatory requirements and advancing technology have driven rapid evolution of RMS technology. As such, now is the time to consider what your agency is doing to track your personnel and incidents.
Threats to doing nothing
As EMS leaders, we threaten our organization’s resilience and progress when we make opinion-based decisions. We value our members’ input and want to improve the work environment; however, it’s a roll of the dice to make decisions based on anecdotes. We need data – and the right kind of data.
For example, management constantly hears about the burnout of the ambulance staff. Paramedics talk about a high call volume, lack of sleep, and the need for additional ambulances. Here’s some data that supports this: A study published in the Journal of Clinical Sleep Medicine looked at a nationally representative sample of 7,000 firefighters in 66 fire departments for an obstructive sleep disorder, insomnia, restless leg syndrome, and shift work disorder. Researchers found that about 37% of the firefighters screened positive for at least one sleep disorder. That data makes a compelling case, but we need our department-specific data to fully justify our plan to address these issues.
An emotional connection could have driven a fire chief to request additional personnel and apparatus – certainly a positive addition, but what would happen if the governing board asked the fire chief to prove how busy their ambulances are and how they were fair with a national standard? This governing board has identified, and rightfully so, a hole in the argument. The needed data for this specific department has become the missing piece of the data puzzle.
The value of the data
Valid and accurate RMS data allows your organization to make informed decisions that contribute to your organization’s resiliency. With the example above, the RMS data showed that the average number of night runs was at industry standard levels. The organizational staffing didn’t need an additional 24-hour ALS ambulance. However, the data did show peak hours, which helped support staffing during those hours. In addition, the data supported other options like up-staffing BLS ambulances during those peak times, which lowered the responses for the ALS ambulances.
Beyond the intelligent staffing decisions that this data provided, leadership now has factual information it can provide its members. A better understanding of the response data will help your members make informed decisions about rest periods and higher risk times for high call volume. Training decisions can be adjusted and manipulated based on valid data sets that support the timing of your essential training events. Supervisors can now talk with their crews about intelligent sleeping suggestions, like getting to bed at specific times and not staying up until midnight watching a movie. If the data shows an average of two calls per night, then going to bed at midnight will likely result in a sleep-deprived provider at 0700 wakeup.
Innovative RMS vendors are bringing instant access to patient histories so agencies can see if you or anyone in your department has interacted with the patient before in real-time. Your members are then armed with all the information they need to make the right decisions. Also gone are the days of handing off a paper record at the emergency hospital. On a busy day, providers return at the end of the shift and spend hours doing reports when they could have done that on the apparatus on the way back to the station. New RMS unlocks mobile access so providers can finish reports from anywhere, anytime. Older RMS might require 15-30 minutes to fill out an incident report on average and 45 minutes to an hour for more complex reports; the newer systems reduce those standard report times to 5-7 minutes, freeing up firefighters and paramedics to do more value-added activities.
One of our most significant challenges in public safety is articulating our value in a quantifiable manner. This challenge is prevalent in most homeland security domains because the primary goal is to prevent or mitigate events. However, to put a value on prevented and mitigated events, agencies must measure what didn’t happen as well.
A standard strategy of public safety agencies is to measure and report events that did happen and the associated losses. However, measuring losses demonstrates the magnitude of the event more than illuminates the effectiveness of the agencies tasked to prevent or mitigate it. EMS must change the narrative by measuring, quantifying and reporting the value of saves instead of losses in a standard format.
While our work with data use has significantly improved during the last 20 years, EMS has only scratched the surface in terms of our potential here. Medical responses require substantially greater documentation due to medical and legal oversight. Therefore, establishing systems that ensure the collection and management of quality data is critical to use it effectively.
Over the next 30 years, the amount of data available to the profession will transform how EMS operates. As leaders, we need to move toward the front of this ever-changing environment and ensure that we make informed decisions and have valid data to ensure our sustainability and resiliency.